ICD-10-PCS Billable Code

01DC3ZZ

Extraction Pudendal Nerve to No Qualifier with No Device, Percutaneous Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body System1 Peripheral Nervous System
OperationD Extraction
Body PartC Pudendal Nerve
Approach3 Percutaneous
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Pulling or stripping out or off all or a portion of a body part by the use of force

Procedure Overview

This family covers the forcible pulling or stripping of all or part of a peripheral nerve, most commonly seen in procedures like nerve stripping for certain chronic pain conditions or the mechanical avulsion of a nerve segment. It is a less common operation in this body system than in others, since peripheral nerves are usually cut or dissected free rather than pulled out under force.

When it is performed, the intent is typically to eliminate a nerve's function entirely by physically removing it through traction rather than sharp dissection, often for a nerve that is already damaged beyond repair or is the source of persistent, difficult-to-treat pain.

Anatomy & Axis Detail

Pudendal Nerve

The pudendal nerve gathers fibers from the S2 through S4 roots and threads through Alcock's canal alongside the internal pudendal vessels before fanning out to the perineum, external genitalia, and pelvic floor. When something foreign is lodged against this nerve - a stray suture, a fragment of mesh, or scar tissue left from a prior sling or vaginal repair - a surgeon may free it by pulling the material away from the nerve without cutting the nerve itself, which is what distinguishes this procedure from a neurectomy. Because the canal is narrow and shares space with the pudendal vessels, laterality and the exact segment involved matter for documentation, since compression here is a recognized cause of chronic pelvic and genital pain.

Approach: Percutaneous

Percutaneous describes entry by needle or instrument puncture through the skin or mucous membrane to reach the site of the procedure, without cutting the tissue open or using a visualizing scope. It differs from Open in that the site itself is never exposed, and from Percutaneous Endoscopic in that no endoscope is used to see internal structures. Common examples include needle biopsies and injections.

Coding & Documentation

This code is used only when the documentation specifically describes force, such as pulling or stripping, being used to remove the nerve or a portion of it, rather than a scalpel or cautery cutting it free. Because this method is uncommon for peripheral nerves, coders should read the operative note carefully to confirm the technique actually matches Extraction and was not simply described loosely by the surgeon when a standard excision was performed. Vein stripping terminology from vascular procedures is sometimes mistakenly carried over to nerve cases, leading to incorrect code selection when the actual technique was sharp dissection.

Commonly Confused With

ExcisionExtraction is easily confused with Excision, and the deciding factor is technique: Excision uses cutting instruments to remove a defined portion of the nerve, while Extraction relies on pulling force.
DetachmentIt can also be confused with Detachment when an entire limb segment is being removed, since Detachment applies specifically to cutting off an extremity rather than removing a nerve by force.